Provider Demographics
NPI:1801192950
Name:NEW RICHLAND DRUG PC
Entity type:Organization
Organization Name:NEW RICHLAND DRUG PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARAMBEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-402-0577
Mailing Address - Street 1:1615 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-1868
Mailing Address - Country:US
Mailing Address - Phone:507-377-1062
Mailing Address - Fax:
Practice Address - Street 1:1615 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-1868
Practice Address - Country:US
Practice Address - Phone:507-377-1062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MN2636323336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2128599OtherPK